A Pennsylvania bishop named in a grand jury report on rampant sexual abuse by Roman Catholic clergy said Friday he has “profound remorse” and offers his “heartfelt apology” to the victims.

Speaking at a Mass of forgiveness, Harrisburg Bishop Ronald Gainer opened by reading the first paragraph of this week’s stunning report that said over 300 predator priests had abused more than 1,000 children in six Pennsylvania dioceses. Forty-five of the priests named in the report served in the Harrisburg diocese.

The first paragraph of the nearly 900-page report said the grand jury knows the truth: that child sex abuse within the Catholic church happened everywhere.

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“In the name of our global church, I voice again my heartfelt sorrow and sincere apology to all survivors of clergy sexual abuse,” Mr. Gainer said.

Parishioners pray before a mass led Friday by Bishop Ronald Gainer in Harrisburg, Pa.

Matt Rourke/The Associated Press

While acknowledging the church is faced with a “spiritual crisis,” Mr. Gainer said most of the abuse happened long ago. The diocese has taken “significant and effective measures to protect our children and remove any person who intends to do harm to them,” he said.

The grand jury report criticized Mr. Gainer for failing to advocate the defrocking of an abusive priest. The diocese defended Mr. Gainer, saying he took swift action against that priest and another abusive priest after becoming bishop in 2014.

In early August, the diocese released the names of 71 priests and other members of the church who had been accused of child sex abuse and said it was holding accountable all Harrisburg bishops of the last 70 years, announcing their names would be stripped from church properties.

Friday’s Mass attracted an unusually large turnout of some 350 worshippers. They included Irene Youngman, a retired social worker from Hershey, and her friend, Susan Shebosky, a retiree from Harrisburg, each of whom held a cigar box filled with white ribbons. They intended to distribute the ribbons as a way to show support for abuse victims.

Youngman said she was so angry when the grand jury’s report came out Tuesday that she stayed home from Mass that day.

“There’s such a sense of betrayal. And an anger I have that the hierarchy isn’t responding,” she said. “I hope they will do more than they’ve done already. Hold the bishops accountable.”

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Ms. Shebosky encouraged fellow Catholics to speak up.

“Too many Catholics are in our homes, gnashing our teeth about this and I think we need to come out in a positive, supportive way and not let this be brushed aside,” she said.

Steve Ciccocioppo Sr., a retired rail worker from Harrisburg, said the church had suffered a “black eye,” but predicted it would “withstand and grow stronger.” Mr. Ciccocioppo, who said he is a friend of Mr. Gainer’s, expressed confidence in the bishop’s leadership.

“He’s deeply in turmoil about it, but he’s going to put an end to this. Things are in the process of changing that need to be changed,” he said.

The grand jury report faulted Mr. Gainer over his handling of the case of the Rev. Joseph Pease, an abusive priest who retired in 2003 after admitting to sexual misconduct with a minor. In a 2014 letter to the Vatican, Mr. Gainer said he didn’t want to kick Pease out of the priesthood altogether, asking that he instead live the rest of his life “in prayer and penance, without adding further anxiety or suffering to his situation, and without risking public knowledge of crimes.”

The report cited another 2014 case in which Mr. Gainer failed to call for the defrocking of a priest who’d admitted that he’d sexually abused seven young girls, raping one of them over a period of years. The Rev. James Beeman had been suspended from ministry since 1991; he died in 2016.

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The diocese said in a statement that since canonical trials weren’t a viable option against either priest at the time, Mr. Gainer took action to make permanent the existing penalties against each one.

The form letter that Mr. Gainer sent in each case “is regrettably not written well and does not accurately represent the action that was taken,” the statement said. “Unlike recent attempts to portray this as a cover up, this was the only means of resolving their canonical status.”

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